Wildfires blazing across North America and Australia, heatwaves scorching Europe and Asia, cyclones ravaging Africa and the Caribbean. Climate change is already here, and it’s only going to get worse. But it isn’t just hurting the planet. It’s hurting us.
Climate change is already affecting our health, a new report from The Lancet confirms, and it’s hitting children and the elderly particularly hard. Children will not only face rapid and unprecedented changes over the course of this century, but they are also the most susceptible to illnesses like dengue, diarrhea, asthma, malnutrition and more—as wildfires choke our lungs, storms and floods spread cholera, and rising temperatures bring more mosquito-borne illnesses. The health of the elderly is also disproportionately affected by the climate crisis, especially heatwaves.
The Lancet Countdown report, which has been updated every year since 2015, emphasizes what many experts have warned with increasing urgency: improving health care has to be a central part of climate change preparedness.
“The most immediate and direct impact of a changing global climate on human health is seen in the steady increase in global average temperature,” the report’s authors wrote. Every region on the planet has seen a rise in record-breaking heatwaves, which are becoming more frequent, intense, and longer-lasting. In 2018, heatwaves hit 220 million more people than they did in 1986–2005, on average. Severe heat doesn’t just make us irritable and uncomfortable. Heatwaves cause heat stroke, damage kidneys and exacerbate congestive heart failure, among other health issues.
Then there are the wildfires. Three-quarters of the globe saw an increase in fires in the past few years—especially in China and India, where a total of 38 million more people felt the growing heat from uncontrolled blazes in 2015–18. Smoke from wildfires, which can spread hundreds of miles, makes asthma, allergies and other chronic diseases much worse. Every year, seven million people die because of air pollution, which is “principally driven by fossil fuels, and exacerbated by climate change,” the report’s authors wrote.
Changing environmental conditions also further the spread of diseases. Mosquitoes thrive in warmer temperatures, and in pools of water left by storms and floods. As they move into new territory on a warming globe, the insects bring malaria and dengue to even more people. These hotter temperatures are perfect for the transmission of dengue fever, researchers say, and Vibrio bacteria—which cause cholera, infections, stomach inflammation and blood poisoning—are also flourishing, especially along coastlines.
Food is becoming less nutritious and harder to grow in a changing climate, with harvests damaged by cycles of drought and flooding. In addition, climate change affects migration, poverty, conflict, and mental health among “people of all ages and all nationalities,” the authors said—which has complicated and wide-ranging effects on health and well-being.
If nothing is done to curb global emissions, children born today will experience a world that is four degrees Celsius hotter, on average, than temperatures before the Industrial Age, Nick Watts, the lead author of the Lancet study and a global health researcher at University College London, told me by phone.
“A four-degree world is something that no human has ever experienced before,” Watts said. And while researchers have climate models of what the world might look like in those conditions, he added, we don’t have any models of how public health will be affected in the long term.
The early effects, however, are already upon us. “People are already dying from preventable climate-related causes—and that will only get worse unless we take the right steps,” Colin Carlson, a researcher at Georgetown University who has mapped the spread of diseases like dengue in a changing climate, told me over email. Carlson, who was not affiliated with the Lancet report, says the study makes it clear “how our future depends on choices.”
Even with aggressive policies in place to limit greenhouse-gas emissions, health care will still need to improve in order to address existing and future climate-related crises. Health systems are already straining under the pressure of these illnesses, the report’s authors said, and strengthening these systems will be key in responding to a changing world. In fact, health now accounts for 5 percent of all spending on climate adaptation, the report said.
More than half of the cities surveyed in the report said they expected climate change to “seriously compromise” their health infrastructure. One-third of countries now provide climate information, including data on weather and water, to the health sector. And over half of the countries in the world have established national health emergency systems, planning for everything from disease outbreaks and heatwaves to conflict and financial crises.
Early warning systems, Watts said, can help combat the spread of malaria and dengue, letting people know under which conditions mosquitoes and diseases spread, allowing them to stock up on vaccines and medications, and alerting doctors and nurses who will need to be trained to recognize symptoms and treat the diseases. As heatwaves strike around the globe, officials also need to know where the vulnerable people—those who work outdoors, the elderly, the sick—are located; they need to make sure they have enough baseload power so their air conditioning doesn’t fail; and they need to have enough ambulances and staffers on hand during these extreme events.
Climate change also raises the stakes for the universal health care debate, as a safety net for climate-driven healthcare crises. “It’s never going to be as simple as a world where we solve climate change or we don’t,” Carlson said. “But if we don’t solve climate change, universal healthcare will dramatically change how we feel that failure.”
Staying “well below two degrees Celsius” of global temperature rise would help limit catastrophic effects, the Lancet authors noted, but they also pointed out that “current progress is inadequate” to meet that goal. In fact, the world emitted an all-time high of 33.1 gigatons of CO2 from burning fossil fuels in 2018, and total greenhouse-gas emissions from all sources were the highest ever recorded in 2017.
“Without accelerated intervention, this new era will come to define the health of people at every stage of their lives,” the authors wrote. Indeed, that era has already started. The time when climate change could be considered separate from health care is already behind us.
Putting climate change into healthcare terms could help reconceptualize the debate. “It turns out, all of the things you want to do to respond to climate change, they’re just sensible, cost-effective public health interventions,” Watts told me. “Climate change is not about polar bears, not about 2100, and it’s not about a country no one cares about, like New Zealand,” he joked. (Watts is Australian.) Then he sobered again: “It’s about 2019. It’s about human health, which is far more tangible than parts-per-million of CO2. And it is about that child standing next to you.”